Spit and Demolish

(With apologies to Sláine who I hope doesn’t pick me up on any mistakes or omissions!)

I suppose most of you know I’m a dentist.  Never really pushed the point but I’ve been doing this for about 37 years.  What’s bad about this is that I’ve been doing this for 37 years, what’s good about it is I have seen what happens to people’s oral health over a long period of time, and under a wide variety of circumstances. Now I don’t intend this to be a discussion about Fluoride, because I don’t want to talk about that!

So, what’s this got to do with triathlon?

Well let’s go back a step!  And I’ll try to keep this simple:)  I’d like to talk to you about two things!  Enamel, and Saliva!

Enamel:

This is the hard-outer covering of your teeth. Its fantastic stuff. It’s the hardest material in the human body and it’s what makes your teeth look pretty. It’s the pearly part of your “pearly whites”.

However, it only covers the top part of your tooth (the crown) and you only get a certain amount of it! Once it’s gone, it gone, you won’t grow anymore!

Not only that but if your gums recede you expose tooth structure not covered by enamel which is much softer, harder to clean, and kind of alive (=sensitive). Similarly, if you wear your way through it from the top, which happens more rapidly in people who grind their teeth!

Saliva:

Ah yes, good old spit or slag or drool or whatever you want to call it.

Saliva has a myriad of functions, it also is fantastic stuff. It’s one of those things you take for granted till it’s not there.

I’ve seen what happens when it’s not there!

People who have kept their teeth in terrific condition for 20, 30, 40 + years, will watch them disintegrate before their eyes because their mouth has all of a sudden dried up!

So why does your mouth dry up?

Well it’s part of ageing, but it is accelerated via side effects of medications that so many of us are on as we get older. There are lots of other reasons as well and perhaps the one we are really interested in is, dehydration!

So, what does saliva do that’s so important?

Well firstly it buffers acid and secondly, it’s so full of tooth goodies like, Calcium and Phosphorous that it can actually repair the early stages of enamel destruction caused by acid.

(Now I’m not going to get into a discussion about Fluoride here but suffice to say that Fluoride is an ally in this process)

But where does the acid come from?

Well some germs which live in, and actually form a large part of Plaque (the white sludgy stuff that we dentists plead with you to try and clean off), will produce acid when they get to eat something sugary, i.e. sweet! This acid starts eating away the enamel and this process is called dental decay! If we stop the supply of sugar this gives time for the minerals in saliva to repair the damage, but this takes time. So, the more often we supply the little nasties with sugar, the less time we give saliva to repair the damage and the process is favouring more acid damage compared to saliva repair, and a “hole” begins to develop!

This is why if you have 10 sweets it’s better to eat them all at once rather than 1 every few minutes!

I hope you’re following me here.

But acid can also come from extrinsic sources!

Aha we approach the crux of the matter.

Soft drinks, sports drinks, colas, even flavoured mineral waters are acidic. Very acidic!

For example, Coke has a pH of 2.5, Sprite 3.3.

Not only this but they have loads of sugar in them, up to 13 teaspoons!!

The energy drinks are worse!

OK so what about zero sugar drinks?

Well Powerade zero has a pH 2.93!

You see when they add flavour they add Citric acid (sometimes Malic acid as well) and in Coke’s case, phosphoric acid also.

In sports drinks the electrolytes taste bad so they add flavour, i.e. Citric acid. By the way citric acid is coded as 330 in the ingredients!

Now I know I said I wanted to talk about two things, well I’ve got a third for you to consider!

Actually, there’s a couple others I’ll throw in, but I am a dentist you know, and as we all should remember I’m a bit weird! (Threw that in to see who read to this point)

EROSION:

Before I go on, remember those pH values I was talking about.

Erosion = “The chemical dissolution of tooth structure in the absence of bacteria when the environment is acidic i.e. pH < 4.0”

“Consumption of beverages of pH <4.0 results in immediate softening of the tooth surface making it more susceptible to removal by Abrasion (=Rubbing), and Attrition (=tooth grinding)!”

(By the way Fluoride works on both sides of this equation, it makes enamel more resistant to acid AND it makes the repair process more efficient- but as I said I don’t want to talk about Fluoride)

Is the light beginning to dawn?

Let’s look at an endurance athlete e.g. a Triathlete!

In this situation of endurance sports, an athlete will dehydrate to varying degrees.

I have discussed this before in my “Do Ants Have Muscles “article. We cannot replace enough fluid to keep up with the amount we lose, so we progressively dehydrate.

As we said before in this situation our salivary flow reduces, i.e. we get a dry mouth.

We compensate by using varying kinds of fluids which are basically all (except water) acidic!

So, we are attacking our beautiful enamel with acid, at the same time as taking away its main protector (Saliva – come on keep up!)

Not only this, but while our enamel is in this precarious situation, we are consuming lots of sugar (gels bars etc.) and the Alpha personalities among us will be grinding (or clenching) their teeth! (you know who you are)!

Also, we usually sip on these drinks at regular intervals, and so don’t give what saliva we do have time to neutralize the acid or begin some repair work!

All this adds up to a situation where your enamel is at high risk of destruction!

The longer the event, the hotter the environment the more pronounced this effect will be. So, for example, an Ironman in somewhere like Hawaii, is pretty bad news!

I wonder why I said that, hmm I don’t know I think all this Fluoride is getting to me! (Bugger I said it again didn’t I)

Anyway, it paints a distressing picture for our precious enamel doesn’t it? 🙁

So, what can we do about this?

Well I mentioned this amazing stuff earlier, it’s called water!

It’s free, its supplied during all Triathlon events and it can even have Fluoride in it. But I don’t want to get in a discussion about Fluoride!

It has neutral pH, it buffers and washes away acid and it rehydrates!

You could always BUY bottled water which is still pretty good (but no fluoride – usually – but I don’t want to get in a discussion about Fluoride)

So, what if you separated your fluids from your carbs i.e. you have gels for your carbs and you have electrolytes in your bottles without carbs. So, while this takes the sugar out of your fluid and thereby reduces the frequency of sugar exposures to your teeth, it still doesn’t solve the acid effect.

OK so what if you have a super concentrated bottle of electrolytes which you periodically take a mouthful of but follow that with plain water till you are due for your next load of electrolytes (and gels). This will help neutralize the acid effect AND give some time for your limited saliva to do some repair work on your teeth.

If the water has Fluoride in it even better, DAMN I did it again!

AND DON’T GRIND YOUR BLOODY TEETH!

All of a sudden, we have an excellent nutrition strategy for Ironman which not only covers carbs, electrolytes and fluids but is kind to your teeth at the same time!

Now I know Ironman is an extreme example, but the principles remain the same for all other events and indeed training for these events!

So, use water! Even swish it around your mouth periodically. (with Fluoride if possible -aww crap can’t help myself)

Keep as hydrated as you can!

Keep your teeth apart when you remember!

Avoid having a constant flow of carbs and have them in definite doses with time in between!

OK now after paying attention to all that I’m going to ask you a question or two!

Is it better to clean your teeth before or after you have a sweet treat?

If you get this wrong I will be grumpy for the rest of the year!!!

What if you DID use a toothpaste that had Fluoride in it, would it be good idea to not rinse it all out after brushing, thereby leaving it contact with your teeth for longer?

Sorry, Sorry, Sorry oh boy you just won’t leave the F word alone, will you Gaz!

Also, when your dentist says you’d look really good with some pretty veneers on your teeth!

The first part of this process is to drill off about half a millimeter of enamel from the entire front surface of your front teeth!

Just saying!

And you wonder why I’m grumpy and weird!

Gaz